NPIMap

Organization Active NPI

Sauk Prairie Healthcare Inc

  • Certified Registered Nurse Anesthetist
  • Prairie Du Sac, WI
National Provider Identifier
1396884474
Registry record updated Feb 22, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Certified Registered Nurse AnesthetistTaxonomy code 367500000X
Legal business name
SAUK PRAIRIE HEALTHCARE INC
Practice address
260 26TH St
Prairie Du Sac, WI 53578-1599
Phone
(608) 643-3311
NPI assigned
Feb 6, 2007
Last updated
Feb 22, 2018By the provider in NPPES
Organization subpart
Yes
Parent organization
SAUK PRAIRIE HEALTHCARE INCAs reported in NPPES

NPPES NPI Registry

Updated by the provider on Feb 22, 2018

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name
James Dregney
Title
Cfo
Phone
(608) 643-7212

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Certified Registered Nurse Anesthetist 367500000X WI Primary

Addresses

Primary practice location

260 26TH St
Prairie Du Sac, WI 53578-1599

Mailing address

PO Box 70
Prairie Du Sac, WI 53578-0070
Phone (608) 643-3311

Other identifiers 2

IdentifierTypeStateIssuer
32764200MedicaidWI
CC7369OtherRAILROAD MEDICARE

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in WI2 enrollments

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
O20031208000206 WI Part B Supplier - Clinic/Group Practice 8224948054 Receives reassigned benefits from 145 practitioners
13 other NPIs on this enrollment
This NPI is an additional NPI on the enrollment
Practice locations: Lodi, WI; Mazomanie, WI; Plain, WI; Prairie Du Sac, WI; Sauk City, WI; Spring Green, WI
O20040129001089 WI Part B Supplier - Clinic/Group Practice 8224948054 Receives reassigned benefits from 15 practitioners
Practice locations: Prairie Du Sac, WI

Other NPIs with the same Medicare PAC ID 8

NPIs whose Medicare enrollments share a PECOS associate control ID (the same enrolled entity).

Other NPIs on the same Medicare enrollment 13

NPIs listed together on one Medicare enrollment, typically parts of the same organization.

View all 13

National Provider Directory

National Provider Directory
Part of
Sauk Prairie Memorial H

Practitioners & affiliated clinicians

Practitioners 149

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

View all 149

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1170720000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1519257600000",
    "number": "1396884474",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 70",
            "city": "PRAIRIE DU SAC",
            "state": "WI",
            "postal_code": "535780070",
            "telephone_number": "608-643-3311"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "260 26TH ST",
            "city": "PRAIRIE DU SAC",
            "state": "WI",
            "postal_code": "535781599",
            "telephone_number": "608-643-3311"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SAUK PRAIRIE HEALTHCARE INC",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "SAUK PRAIRIE HEALTHCARE INC",
        "enumeration_date": "2007-02-06",
        "last_updated": "2018-02-22",
        "status": "A",
        "authorized_official_last_name": "DREGNEY",
        "authorized_official_first_name": "JAMES",
        "authorized_official_title_or_position": "CFO",
        "authorized_official_telephone_number": "608-643-7212"
    },
    "taxonomies": [
        {
            "code": "367500000X",
            "taxonomy_group": "",
            "desc": "Nurse Anesthetist, Certified Registered",
            "state": "WI",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "32764200",
            "state": "WI"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RAILROAD MEDICARE",
            "identifier": "CC7369",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Prairie Du Sac, WI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 22, 2018; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.